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| Version 5 | Version 6 |
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| Greater Manchester 'to control £6bn NHS budget' | Greater Manchester 'to control £6bn NHS budget' |
| (about 1 hour later) | |
| The £6bn health and social care budget for Greater Manchester is to be taken over by the region's councils and health groups, it is understood. | The £6bn health and social care budget for Greater Manchester is to be taken over by the region's councils and health groups, it is understood. |
| The devolved power agreement is expected to be confirmed by the Chancellor George Osborne on Friday. | The devolved power agreement is expected to be confirmed by the Chancellor George Osborne on Friday. |
| It will see NHS England hand spending decisions on regional healthcare to local politicians, clinical commissioning groups and NHS trusts. | It will see NHS England hand spending decisions on regional healthcare to local politicians, clinical commissioning groups and NHS trusts. |
| The plan will come into force from April 2016. | The plan will come into force from April 2016. |
| It will mean local leaders and ultimately Greater Manchester's new directly elected mayor will control how budgets are allocated. | It will mean local leaders and ultimately Greater Manchester's new directly elected mayor will control how budgets are allocated. |
| It is hoped that by integrating health and social care services, the change will ease pressure on hospitals and help to improve home care services for patients who need it. | It is hoped that by integrating health and social care services, the change will ease pressure on hospitals and help to improve home care services for patients who need it. |
| A shadow Greater Manchester Health and Wellbeing board will be appointed, it is understood. It would work closely with existing clinical commissioning groups of GPs. | A shadow Greater Manchester Health and Wellbeing board will be appointed, it is understood. It would work closely with existing clinical commissioning groups of GPs. |
| The board is expected to run from April, before control of the budget is handed over a year later. | The board is expected to run from April, before control of the budget is handed over a year later. |
| A Labour spokesperson said: "We have yet to see the full details of this proposal, and people working in the NHS will want to be persuaded of the case for a new layer of management. | A Labour spokesperson said: "We have yet to see the full details of this proposal, and people working in the NHS will want to be persuaded of the case for a new layer of management. |
| "The government also ought to get the message that change is needed for the whole of England, and not just Greater Manchester." | "The government also ought to get the message that change is needed for the whole of England, and not just Greater Manchester." |
| National Analysis | National Analysis |
| Nick Triggle, BBC health correspondent | Nick Triggle, BBC health correspondent |
| Ever since the NHS was created in 1948, it has remained separate to the council-run care system that oversees help in the home with tasks such as washing and dressing and care home places. | Ever since the NHS was created in 1948, it has remained separate to the council-run care system that oversees help in the home with tasks such as washing and dressing and care home places. |
| But as the decades have gone by and health care has shifted from curing illnesses to helping people manage long-term conditions such as dementia and heart disease, there has been an increasing sense that the two systems need to become more joined up. | But as the decades have gone by and health care has shifted from curing illnesses to helping people manage long-term conditions such as dementia and heart disease, there has been an increasing sense that the two systems need to become more joined up. |
| All three main political parties have their own ideas of how this should be done - and NHS England chief executive Simon Stevens signalled his support for greater integration with the publication of his Five-Year Forward View last autumn. | All three main political parties have their own ideas of how this should be done - and NHS England chief executive Simon Stevens signalled his support for greater integration with the publication of his Five-Year Forward View last autumn. |
| But Greater Manchester has taken the bull by the horns and proposed a pooling of budgets. | But Greater Manchester has taken the bull by the horns and proposed a pooling of budgets. |
| At this stage (and it must be said the details are still emerging) it seems to mirror what is being rolled out in Scotland and what has happened in Northern Ireland since the 1970s. So will this catch on across the rest of England? | At this stage (and it must be said the details are still emerging) it seems to mirror what is being rolled out in Scotland and what has happened in Northern Ireland since the 1970s. So will this catch on across the rest of England? |
| It could be argued it already has. From April there will be small pooled budgets in every 151 local authority areas - including the 10 boroughs in Greater Manchester - as part of the government's Better Care Fund initiative. They will be worth £5.3bn in total. | It could be argued it already has. From April there will be small pooled budgets in every 151 local authority areas - including the 10 boroughs in Greater Manchester - as part of the government's Better Care Fund initiative. They will be worth £5.3bn in total. |
| That represents less than 5% of the combined spending on health and care nationally, but is clearly a step towards full integration. | That represents less than 5% of the combined spending on health and care nationally, but is clearly a step towards full integration. |
| Richard Humphries, assistant director of the King's Fund think tank, said a full transfer of responsibility would be a reform "on a breathtaking scale" but could pose serious risks. | Richard Humphries, assistant director of the King's Fund think tank, said a full transfer of responsibility would be a reform "on a breathtaking scale" but could pose serious risks. |
| Speaking on BBC Radio 4's Today programme, he said: "Depending on the detail - and the detail is really crucial and we don't have that yet - you could either see this as a triumph for local democracy or creating real risks of yet another reorganisation of the NHS when it's barely recovered from the last one." | Speaking on BBC Radio 4's Today programme, he said: "Depending on the detail - and the detail is really crucial and we don't have that yet - you could either see this as a triumph for local democracy or creating real risks of yet another reorganisation of the NHS when it's barely recovered from the last one." |
| Councillor Mike Connolly, Labour leader of Bury Council, said: "Those decisions need to be made in Greater Manchester and not Westminster, and I welcome any form of devolution to the city region. | Councillor Mike Connolly, Labour leader of Bury Council, said: "Those decisions need to be made in Greater Manchester and not Westminster, and I welcome any form of devolution to the city region. |
| "We are all agreed, certainly in the Labour Party, that health and social care must be integrated because it's about providing that primary care - and it can only be good for healthcare across Greater Manchester." | "We are all agreed, certainly in the Labour Party, that health and social care must be integrated because it's about providing that primary care - and it can only be good for healthcare across Greater Manchester." |
| Regional Analysis | Regional Analysis |
| Kevin Fitzpatrick, BBC Radio Manchester | Kevin Fitzpatrick, BBC Radio Manchester |
| If the initial devolution deal for Greater Manchester was ground breaking, then this development changes the shape of local government in a way that would have been unthinkable just a few months ago. | If the initial devolution deal for Greater Manchester was ground breaking, then this development changes the shape of local government in a way that would have been unthinkable just a few months ago. |
| By taking control of the entire NHS budget, the area's 10 councils, and ultimately the elected mayor, will be able to join up health and social care in a way that's never been possible before. | By taking control of the entire NHS budget, the area's 10 councils, and ultimately the elected mayor, will be able to join up health and social care in a way that's never been possible before. |
| In addition to control of the £2bn of budgets agreed last year for skills and training, transport and planning, the £6bn that comes with this deal means local politicians will decide how more than a quarter of government money is spent in their area. | In addition to control of the £2bn of budgets agreed last year for skills and training, transport and planning, the £6bn that comes with this deal means local politicians will decide how more than a quarter of government money is spent in their area. |
| Local politicians describe the move as an incredible opportunity, but it also comes with risks with just over a year to plan before the money and a huge amount of new responsibility is handed over. | Local politicians describe the move as an incredible opportunity, but it also comes with risks with just over a year to plan before the money and a huge amount of new responsibility is handed over. |
| Greater Manchester must ready itself to break more new ground as devolution picks up pace. | Greater Manchester must ready itself to break more new ground as devolution picks up pace. |